What is the difference between clopidogrel and warfarin

Additional references were identified by reviewing reference citations of articles retrieved. Study selection and data extraction: Applicable data were extracted from published reports and studies that included either clinical outcomes or adverse events.

Data synthesis: Clinical guidelines recommend the combination of antiplatelets and anticoagulants based largely on writing committee consensus. To date, only one randomized clinical trial has evaluated the safety and efficacy of adding warfarin to dual antiplatelet therapy ie, triple antithrombotic therapy.

Other published data are from case series, observational studies, and case-controlled studies primarily of patients undergoing PCI with intracoronary stent placement.

This demonstration of no benefit from a frequently used dual and triple anticoagulant combination and significant harms places this article in our Less Is More classification. Correspondence: Morten L. Author Contributions: Dr Hansen had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Obtained funding : Torp-Pedersen. Administrative, technical, and material support : Torp-Pedersen.

Role of the Sponsor: Sanofi-Aventis had no role in the design and conduct of the study; in the collection, management, analysis, and interpretation of the data; or in the preparation, review, and approval of the manuscript. Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy Continue. Figure 1. View Large Download. Table 1.

Oral anticoagulants vs aspirin in nonvalvular atrial fibrillation: an individual patient meta-analysis. Aspirin and clopidogrel with or without phenprocoumon after drug eluting coronary stent placement in patients on chronic oral anticoagulation. Safety and efficacy of combined antiplatelet-warfarin therapy after coronary stenting.

Anticoagulant and antiplatelet therapy use in patients with atrial fibrillation undergoing percutaneous coronary intervention and stent implantation implications for bleeding risk and prognosis. Combination therapy with aspirin, clopidogrel and warfarin following coronary stenting is associated with a significant risk of bleeding.

Risk of major bleeding with concomitant dual antiplatelet therapy after percutaneous coronary intervention in patients receiving long-term warfarin therapy. Increased major bleeding complications related to triple antithrombotic therapy usage in patients with atrial fibrillation undergoing percutaneous coronary artery stenting. Dual antiplatelet therapy after percutaneous coronary intervention with stent implantation in patients taking chronic oral anticoagulation.

Antithrombotic therapy in patients treated with oral anticoagulation undergoing coronary artery stenting: an expert consensus document with focus on atrial fibrillation. Atrial fibrillation pharmacotherapy after hospital discharge between and a shift towards beta-blockers. The pattern of use of non-steroidal anti-inflammatory drugs NSAIDs from to a nationwide study on 4.

Long-term compliance with beta-blockers, angiotensin-converting enzyme inhibitors, and statins after acute myocardial infarction. Risk of bleeding in patients with acute myocardial infarction treated with different combinations of aspirin, clopidogrel, and vitamin K antagonists in Denmark: a retrospective analysis of nationwide registry data. Stroke Prevention in Atrial Fibrillation Study: final results.

Boston Area Anticoagulation Trial for Atrial Fibrillation Investigators, The effect of low-dose warfarin on the risk of stroke in patients with nonrheumatic atrial fibrillation. Veterans Affairs Stroke Prevention in Nonrheumatic Atrial Fibrillation Investigators, Warfarin in the prevention of stroke associated with nonrheumatic atrial fibrillation. A multicenter study. Scheiman JMElta GH Gastroduodenal mucosal damage with salsalate versus aspirin: results of experimental models and endoscopic studies in humans.

Adjusted-dose warfarin versus low-intensity, fixed-dose warfarin plus aspirin for high-risk patients with atrial fibrillation: Stroke Prevention in Atrial Fibrillation III randomised clinical trial. Fixed minidose warfarin and aspirin alone and in combination vs adjusted-dose warfarin for stroke prevention in atrial fibrillation: Second Copenhagen Atrial Fibrillation, Aspirin, and Anticoagulation Study.

See More About Anticoagulation. Save Preferences. Privacy Policy Terms of Use. This Issue. Citations View Metrics. Twitter Facebook More LinkedIn. Original Investigation.

September 13, Morten L. Andersen, MD ; Tina K. Schramm, MD ; Steen Z. Study population. Warfarin and platelet inhibitor therapy. Exposure groups. Concomitant medical therapy. End points. Statistical analysis. Sensitivity analyses. Baseline characteristics.

Nonfatal and fatal bleeding. Time trends. Warfarin, aspirin, clopidogrel, or combinations of these drugs and risk of bleeding and ischemic stroke. Bleedings and risk of all-cause mortality. Combination therapies. Strengths and limitations of the study. Editor's Note This study reports bleeding risks in a large observational cohort of over Danish patients with atrial fibrillation and more than 3 years of follow-up.

Access your subscriptions. Access through your institution. Add or change institution. Free access to newly published articles. Purchase access. Rent article Rent this article from DeepDyve. Ticagrelor is taken twice a day. Yes, you can drink alcohol while taking clopidogrel, as long as you stick to the national guidelines of no more than 14 units a week for men and women.

A standard glass of wine ml is 2 units. A pint of lager or beer is usually 2 to 3 units of alcohol. Drinking too much alcohol while you're taking clopidogrel can irritate your stomach. There's a risk that you could get a stomach ulcer. Grapefruit juice decreases the effects of your medicine, so that it may not work as well to prevent clots.

Because of the risk of bleeding, you may need to stop taking clopidogrel for a short time before having surgery or dental work. Do not stop taking clopidogrel without first talking to your doctor or dentist. They'll tell you if you need to stop taking clopidogrel before a procedure.

It's a good idea to mention to the doctor or nurse that you're taking an antiplatelet medicine. Clopidogrel does not affect any type of contraception, including the combined pill and emergency contraception. There's no clear evidence to suggest that taking clopidogrel will reduce fertility in either men or women. But speak to a pharmacist or your doctor before taking it if you're trying to get pregnant.

Clopidogrel does not affect your concentration, so you can drive or ride a bike while you're taking it. If you have been prescribed clopidogrel, you can also boost your health by making some key lifestyle changes.

Page last reviewed: 5 August Next review due: 5 August Clopidogrel - Brand names: Grepid, Plavix On this page About clopidogrel Key facts Who can and cannot take clopidogrel How and when to take clopidogrel Side effects How to cope with side effects of clopidogrel Pregnancy and breastfeeding Cautions with other medicines Common questions about clopidogrel. About clopidogrel Clopidogrel is an antiplatelet medicine. Your risk is higher if you have or have had: a heart attack unstable angina a stroke or "mini-stroke" transient ischaemic attack or TIA peripheral arterial disease an operation on your heart or blood vessels, such as a coronary stent insertion Clopidogrel comes as tablets and is only available on prescription.

Help us improve our website Can you answer a quick question about your visit today? The usual dose for clopidogrel is 75mg once a day. Your doctor may prescribe clopidogrel with or instead of low-dose aspirin. The main side effect of clopidogrel is bleeding more easily than normal.

You may have nosebleeds, heavier periods, bleeding gums or bruising. You can drink alcohol with clopidogrel. But do not drink too much while taking this medicine. It can irritate your stomach. You may need to stop taking clopidogrel for a short time before having surgery or dental treatment, but check with your doctor or dentist first. Clopidogrel can be taken by adults aged 18 and over.

To make sure this medicine is safe for you, tell your doctor if you: have ever had an allergic reaction to clopidogrel or any other medicine have a stomach ulcer or have had stomach ulcers in the past have had bleeding in your brain a brain haemorrhage have a bleeding disorder, such as haemophilia have liver or kidney problems are trying to get pregnant, already pregnant or breastfeeding. You can take clopidogrel with or without food.

Dosage The usual dose is 75mg a day. What if I forget to take it? If you forget to take clopidogrel, take it as soon as you remember. Do not take a double dose to make up for a forgotten dose.

What if I take too much? Taking 1 or 2 extra tablets is unlikely to harm you. Common side effects These common side effects happen in more than 1 in people.

Talk to your doctor or pharmacist if these side effects bother you or do not go away: bleeding more easily than normal — nosebleeds, bruising more easily or bleeding that takes longer to stop diarrhoea stomach pain indigestion or heartburn Serious side effects Serious side effects are rare and happen in less than 1 in 1, people.

Call a doctor as soon as possible if: you're coughing up blood, or there's blood in your pee, poo or vomit the whites of your eyes turn yellow, or your skin turns yellow, although this can be harder to see on brown or black skin — these can be signs of liver problems you feel very tired or have signs of infections, such as a high temperature or sore throat — these can be signs of a blood or bone marrow disorder Serious allergic reaction In rare cases, clopidogrel can cause a serious allergic reaction anaphylaxis.

Information: You can report any suspected side effect using the Yellow Card safety scheme. Visit Yellow Card for further information. What to do about: bleeding more easily than normal — be careful when doing activities that might cause an injury or a cut. Always wear a helmet when cycling. Wear protective gloves when you use sharp objects like scissors, knives, and gardening tools. Use an electric razor instead of wet shaving, and use a soft toothbrush and waxed dental floss to clean your teeth.

See a doctor if you're worried about any bleeding. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.

It can help to eat and drink slowly and have smaller and more frequent meals. If you're in a lot of pain, speak to your pharmacist or doctor. If the indigestion does not go away, it could be a sign that you have a stomach ulcer. Talk to your doctor, they may prescribe something to protect your stomach or switch you to a different medicine. Clopidogrel and pregnancy Clopidogrel is not normally recommended in pregnancy, however it can be taken if needed. Clopidogrel and breastfeeding Only take clopidogrel while breastfeeding if your doctor advises you to.

Non-urgent advice: Tell your doctor if you're:.